Should I wear a mask? National expert from Akron answers your COVID-19 questions

Wednesday

AKRON Dr. Thomas File, chair of Summa Health’s infectious disease division and president of the Infectious Diseases Society of America, has been consulting weekly with the U.S. Centers for Disease Control and Prevention during the coronavirus pandemic.

He also is in touch with other infectious disease doctors worldwide as experts try to gain a better understanding of COVID-19.

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File agreed to answer questions about the latest on the coronavirus and to share his thoughts on Ohio Gov. Mike DeWine’s plan to loosen shelter-at-home orders.

Q: What are your thoughts about how Ohio is rolling back its stay-at-home order?

A: It’s very good from a public health perspective. It’s a very carefully constructed incremental plan. It follows several of the recommendations from our society, including the need for more widespread testing and the ability to treat, isolate and do contact tracing (treating and isolating people who have been in contact with patients).

We also need appropriate supplies of personal protective equipment and we need to continue good health practices of physical distancing, hand hygiene, disinfecting surfaces and use of masks.

Q: Are you concerned that reopening the state, even at a slow pace, could lead to a spike in cases of COVID-19?

A: Yes, but I really hope if the population still abides by these good public health practices and using masks, that will not happen.

Q: DeWine still recommends people work from home and stay home as much as possible. Do you agree?

A: Yes. I would like people to get outside and enjoy the sunshine, but only if we can still maintain the social distance. If a lot of people have to go to a closed space and are working with desks right next to each other, that’s not going to be the best way to prevent spread.

Q: How do you see other places opening up?

A: We have always said this has to be data-driven and not date-driven. As you go slowly and people are complying and there’s not a spike, then it’s reasonable in a graduated way to start opening these up. It’s going to have to be somewhat creative: restaurants are going to have to social distance and people are going to need to wear masks, hand wash and have hand sanitizers. Serving food will probably be different. Theaters will probably have seats blocked off.

Q: Should families still social distance themselves from older parents/grandparents?

A: If older people have underlying risk factors, we’ll have to maintain that. It’s hard for close family members to stay apart. I think everybody is going to have to make individual choices.

Q: There have been some drug-store chains that have begun to offer coronavirus testing to the general population. Is this useful?

A: I will be on a call with the CDC tomorrow night to talk about these tests. It will be helpful to have information within specific communities to understand the number of patients who have the virus. But you do have to consider the tests also. There are two types of tests -- tests for COVID-19, which are identifying the gene sequences of the virus, and have shown some false negatives, and tests for the presence of antibodies in a person to show whether they may have had the virus (which are not widely available yet). Some of the antibody tests have shown false positives and there is a wide variety of antibodies being screened in the tests. We know some of them will be less accurate than others.

Q: There have already been photos of people locally and nationally who are gathering in large groups or not social distancing as states begin to reopen. Is this a concern?

A: Yes. That is what might lead to a surge.

Q: Do you recommend people wear masks?

A: Yes, if you’re leaving home and will be around other people. If you’re raking your yard and no one is 100 feet from you, you don’t need one. If a high number of people are wearing masks, it is protecting you and me.

At the office, sit 6 feet apart and I would still wear a mask. It provides a barrier since an asymptomatic person can still spread the virus within three feet with normal conversation. If that person coughs, it could go 6 to 8 feet.

Q: What about gloves?

A: For normal interactions, gloves don’t play a significant purpose unless you wash your gloves between each interaction. Good hand hygiene does the same thing.

Q: COVID-19 symptoms seem to be evolving. What’s the latest?

A: For the first six weeks, we kept saying the primary symptoms were fever, cough and shortness of breath. Now the CDC is saying the major signs are cough and shortness of breath and then at least two of the following: recurrent chills, sore throat, headache, muscle aches, loss of taste or smell and a swollen or discolored toe.

Q: Do you see the return of larger gatherings of people without proper testing or a vaccine?

A: That’s going to be a bit problematic. We have to consider anybody is potentially infected. It’s going to make it difficult to ramp up large gatherings until you have herd immunity, or a high enough percentage of people who are going to be immune. We are nowhere close to having herd immunity until we have vaccines.

Maybe there can be outdoor concerts where chairs are 6 feet apart. But you won’t be getting thousands of people.

Q: What is the latest on whether someone who has had COVID-19 can get it again?

A: There were observations out of South Korea where patients who were infected and tested negative had a recurrence of symptoms. That could be re-infection or a relapse, we don’t know yet.

I suspect patients who truly have had a clinical illness of COVID-19 will develop immunity.

Limited studies seem to be showing that COVID-19 positive patients who are getting convalescent plasma with antibodies to the virus from a recovered patient is helping. We have done one so far. The patient is still in the hospital and it’s too early to tell.

Q: People are wondering whether camps or sports can safely take place this summer. Some are even questioning fall sports, school and events. What are your thoughts?

A: It’ll depend on how well we comply with social distancing and masks, whether we see spikes and if we have better testing to see what percentage of the population has been infected.

We’re just going to have to see how things go. That’s why we have to go slowly. If we are going to open up to large gatherings (too quickly), I can guarantee we’ll see surges.

For school, there’s going to have to be a lot of innovative changes in how we interact with each other to see whether these processes go forward.

Q: We have heard that we will not back to “normal” until there is a vaccine. Is that true?

A: Yes, it’s going to be a “new normal.” We won’t be hugging or shaking hands like we used to. When you hear it might take 12 to 18 months to develop a vaccine, that’s very rapid. I’m somewhat optimistic that by this time next year, we’ll have a vaccine. But that is unfortunately not going to be available when we really need it, which is our next respiratory season of late November or early December. The concern will be having influenza at the same time.

Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.beaconjournal.com/topics/linfisher

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